The concept of bundled care is gaining awareness in the changing landscape of U.S. healthcare. By offering a single fee for an episode of care, “bundled care” or “bundled payments” is a dramatic change from the traditional fee-for-service (FFS) model where each service (office visit, X-ray, surgery, skilled nursing facility) is paid for separately and quantity of care is incentivized over the quality of care.
As a way to alter the incentives, Medicare's Bundled Payment for Care Improvement Program (BPCI) offers hospitals and post-acute care providers the opportunity and incentive to work together and be rewarded for efficiency, quality, and coordination of care. Under the program, CMS compensates participating providers through a single payment for providing a set of services for an episode of care to Medicare patients. With BPCI models 2,3, and 4 announced on 2/18/14, post-acute care providers can apply by 4/18/14 to receive bundled payments for up to 48 different clinical condition episodes that will end 30, 60, or 90 days after hospital discharge including major joint replacement of the lower extremity (knee & hip replacements) as well as stroke care, and coronary bypass surgery to name a few. With CMS setting the tone, many organizations are poised to explore bundled payment options.
In a recent Becker’s Hospital Review article, Booz & Co. cites their recent thought pieces on Bundled Healthcare, to help hospital executives as they explore bundled models.
The article highlights four factors of bundled offerings that hospital executives should consider: